Alaafia Wellness Retreat Registration June 2024

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Welcome to the registration form for Alaafia Ocean Retreat. WE are excited for this transformative healing retreat that will impact your spirit, body, and mind. Please complete the following registration form. These questions are vital to creating a healing transformative experience that caters to YOU so that YOU may be MORE than well.

Email *

First Name, Last Name *

What is Your Age? *

What is your Birthday? Month/Day/Year *

YYYY

What is your Primary Phone Number? *

Do we have permission to text you? *

Yes

How did you hear about Alaafia Wellness Retreat?

What is your interest in Alaafia Wellness Retreat? *

A 15-30 min phone/zoom call before the retreat with Coach T.J. is required *

I acknowledge

I do not acknowledge

All white attire is required for the Ocean ceremony on Sunday morning of the retreat *

I acknowledge

I do not acknowledge

Professional photographers will take pictures throughout the duration of the retreat. Photographers will take pictures of you while on retreat. You will receive the pictures taken of you. *

I acknowledge

I do not acknowledge

Do you grant permission to Alaafia Wellness Retreat/T.J.'s Wellness Coaching to use your pictures for marketing purposes? *

Yes

Emergency Contact Information: Name, Phone Number, and Email *

Food Allergies/ Food Restrictions *

Please list any medical conditions you may have. If you have no medical conditions type N/A *

A $250 non-refundable deposit is required for Alaafia Ocean Retreat. You will receive an invoice from T.J.'s Wellness Coaching following initial call.

All payments including the cost of the retreat is Tax-Deductible

I acknowledge and agree

I do not acknowledge and do not agree

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Do you need a payment plan to meet retreat cost? *

Yes

Cancellation Policy: There is no refund beginning June 1, 2024. Registrants may cancel for full refund minus the deposit up to May15, 2024. Participants may receive 50% refund May 16-May 31, 2024. Beginning June 1, 2024 there is no refund. *

I acknowledge

I do not acknowledge

Liability Statement: T.J,'s Wellness and Alaafia Wellness Retreat, Natural-WE Community and its staff are not responsible for any unforeseen circumstances such as injury during our low risk activities, or due to natural disasters. *

I acknowledge

I do not acknowledge

Covid-19 Disclaimer- I acknowledge that T.J.'s Wellness, Alaafia Wellness Retreat, Natural-WE Community and it's staff are not liable if anyone contracts COVID-19 during retreat. I agree to all U.S. public health protocol. This includes safety regulations deemed necessary by Alaafia Ocean Retreat Staff including temperature checks, regular use of lysol, clorox wipes and cleaning supplies, open air activities, etc. *

I acknowledge and agree

I do not acknowledge and do not agree

Travel Disclaimer- I acknowledge that T.J.'s Wellness, Alaafia Wellness Retreat, Natural-WE Community and it's Staff are not liable for any hurt, harm or injury to, from or during retreat. *

I acknowledge and agree

I do not acknowledge and do not agree

Required

Further details about the retreat and retreat itinerary will be sent once retreat candidates complete this registration form, send in their deposit, and have an initial conversation with Coach T.J. *

I acknowledge

I do not acknowledge

A copy of your responses will be emailed to the address you provided.

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